HomeMy WebLinkAboutCrisis Clinic GF0201
AGREEMENT FOR SERVICES
THIS AGREEMENT
t2fùL
made
and
entered
into
this
':]n:L
-V day
of
, 2002, by and between the CITY OF AUBURN, a municipal
corporation of the State of Washington, hereafter referred to as "CITY", and CRISIS
CLINIC, which is located at 1515 Dexter Ave. N. Ste 300 Seattle, WA 98109, a non-profit
corporation organized under the laws of the State of Washington, hereafter referred to as
"AGENCY."
WHEREAS, The AGENCY provides a valuable service to the CITY and its
residents through the provision of ; and
WHEREAS, the CITY is interested in continuing support of the Crisis Line,
including development of additional resources and service sites, for low income Auburn
residents;
NOW, THEREFORE, In consideration of the covenants and conditions of this
Agreement, the parties agree as follows:
I. PURPOSE.
The purpose of this Agreement is to provide for an appropriation to the AGENCY
for providing services as set forth in Exhibit 1, and incorporated herein by this reference
as if fully set forth, to Auburn residents during the 2002 term. This support is in
recognition of the fact that the demand for the services delivered by the AGENCY
continues to rise.
II. SCOPE OF SERVICES.
A. The parties agree and understand that the AGENCY agrees to provide services,
as described in Exhibit "1", which may include development of new resources, to low
--------------------------------------
Agreement - OF-020 1, Crisis Clinic Crisis Line
March 15, 2002
Page 1 of8
income Auburn residents. Services to be provided are set forth in Exhibit "1" to this
agreement, and incorporated herein by this reference as if fully set forth.
B. The Agency agrees to provide at a minimum the services outlined on Exhibit 1.
Said services are to be completed no later than December 31, 2002.
III. TERM.
The term of this Agreement shall commence on January 1, 2002 and shall expire
on December 31, 2002.
IV. PERFORMANCE REPORTS AND COMPENSATION
A. The AGENCY shall provide to the City within 15 days of the close of the second
and fourth calendar quarters a status report containing program statistics regarding the
type and level of services provided to the City of Auburn, as well as financial information
pertaining to the contract agreement and expenditures. The final report, which may
include estimated service levels, shall be submitted no later than December 15, 2002.
Format and contents of these reports are set forth in Exhibits 1 to 3 to this Agreement,
which are incorporated herein by this reference.
B. As full and total payment for the services provided under this Agreement, the CITY
agrees to pay the AGENCY the total amount of $1,500.00 as set forth in Exhibit 1. The
CITY will pay an amount equal to one-quarter of the total amount within thirty (30) days
following the CITY's receipt of quarterly invoices. The required format and content of
quarterly invoices is set forth in Exhibit 4 to this Agreement, and is incorporated herein by
this reference.
~~------------------------------------
Agreement - OF-0201, Crisis Clinic Crisis Line
March 15,2002
Page 2 of8
-------~~_._~---------,...-..-_.__._.~
VI. INDEMNIFICATION.
The AGENCY agrees to defend, indemnify, and hold harmless the CITY, its
elected and appointed officials, employees and agents from and against any and all
claims, demands and/or causes of action of any kind or character whatsoever arising out
of or relating to services provided by the AGENCY, its employees, volunteers or agents
concerning any and all claims by any persons for alleged injury or damage to persons or
property to the extent caused by the negligent acts, errors or omissions of the AGENCY,
its employees, volunteers or agents or representatives. In the event that any suit or claim
for damages based upon such claim, action, loss or damage is brought against the CITY,
the AGENCY shall defend the same as its sole costs and expense; provided that the
CITY retains the right to participate in said suit if any principle of governmental or public
law is involved; and if final judgment be rendered against the CITY and/or its officers,
elected officials, agents and employees or any of them or jointly against the CITY and the
AGENCY and their respective officers, agents, volunteers, employees or any of them, the
AGENCY shall fully satisfy the same and shall reimburse the CITY any costs and
expense which the CITY has incurred as a result of such claim or suit. The provisions of
this section shall survive the expiration or termination of this Agreement.
VII. INDEPENDENT CONTRACTOR/ASSIGNMENT.
The parties agree and understand that the AGENCY is an independent contractor
and not the agent or employee of the CITY and that no liability shall attach to the CITY by
reason of entering into this Agreement except as provided herein. The services required
under this Agreement may not be assigned or subcontracted by the AGENCY without the
prior written consent of the CITY.
--------------------------------------
Agreement - OF-0201, Crisis Clinic Crisis Line
March 15,2002
Page 3 of8
---.---------',----, --....-."..-,.-.------- --~--_._-_._~
VIII. INSURANCE.
The AGENCY shall procure and maintain for the duration of this Agreement
insurance against claims for injuries to persons or property which may arise from or in
connection with services provided by the AGENCY, it agents, employees or volunteers
under this Agreement. The AGENCY agrees to provide comprehensive general liability
insurance and shall maintain liability limits of not less than ONE MILLION DOLLARS
($1,000,000) combined single limit coverage per occurrence for bodily injury, personal
injury and property damage. Where professional services are provided as part of the
services rendered pursuant to this Agreement, as shown in Exhibit 1, the AGENCY shall
also provide and maintain professional liability coverage including errors and omissions
coverage in the minimum liability amount of ONE MILLION DOLLARS ($1,000,000)
combined single limit per occurrence for bodily injury, personal injury and property
damage. Any deductibles or self insured retentions in either policy must be declared to
and approved by the CITY. At the option of the CITY either: The insurer shall reduce or
eliminate such deductibles or self insured retentions as respects the CITY, its officials and
employees; or, The AGENCY shall procure a bond guaranteeing payment of losses and
related investigations, claim administration and defense expenses. The policies are to
contain or be endorsed to contain the following provisions:
1) GENERAL LIABILITY COVERAGE:
The CITY, its elected and appointed officials, employees and agents are to be
covered as additional insureds as respects: Liability arising out of services and
activities performed by or on behalf of AGENCY, its employees, agents and
volunteers. The coverage shall contain no special limitations on the scope of
._~~~~-~._.._.~.~.~-~._~~-~._..__..._.
Agreement - OF-0201, Crisis Clinic Crisis Line
March 15, 2002
Page 4 of8
1--1
protection afforded to the CITY, its elected and appointed officials, employees or
agents.
2) GENERAL LIABILITY AND PROFESSIONAL LIABILITY COVERAGES:
(a) The AGENCY's insurance coverage shall be primary insurance as respects the
CITY, its officials, employees and agents. Any insurance or self insurance
maintained by the CITY, its officials, employees or agents shall be in excess of
the AGENCY's insurance and shall not contribute with it.
(b) Any failure to comply with reporting provisions of the policy shall not affect
coverage provided to the CITY, its officials, employees or agents.
(c) Coverage shall state that the AGENCY's insurance shall apply separately to
each insured against whom claim is bought or suit is brought e,xcept with
respect to the limits to the insurer's liability.
(d) Each insurance policy required by this clause shall be endorsed to state that
coverage shall not be suspended, voided, canceled, reduced in COVE!rage, or in
limits except after thirty (30) days prior written notice by certified mail return
receipt requested has been given to the CITY. The AGENCY agrees to
provide copies of the Certificates of Insurance to the CITY at the time that this
Agreement takes effect.
(e) The AGENCY shall furnish the CITY with Certificates of Insuranc,e and with
original endorsements affecting coverage required by this cl¡¡use. The
certificate and endorsements for each insurance policy are to be signed by a
person authorized by that insurer to bind coverage on its behalf. The CITY
reserves the right to require complete, certified copies of all required insurance
policies at any time.
--------------------------------------
Agreement - OF-0201, Crisis Clinic Crisis Line
March 15,2002
Page 5 of8
- - ___ - __u_ _____ ._~~__..,_,..________...._.__.__"
(f) The AGENCY shall include all volunteers, employees and agents under its
policies or shall furnish separate certificates and endorsements for each. All
coverages for volunteers shall be subject to all the requirements stat.ed herein.
IX. NONDISCRIMINATION.
The AGENCY shall not discriminate under any services or programs to which this
Agreement may apply directly or through contractual or other arrangements on the
grounds of race, color, creed, religion, national origin, sex, age, or the presence of any
sensory, mental or physical handicap.
X. BOOKS AND RECORDS.
The AGENCY agrees to maintain separate accounts and records in accordance
with State Auditor's procedures, including personnel, property, financial and programmatic
records which sufficiently reflect direct and indirect costs and services performed under
this Agreement. The AGENCY agrees to maintain all books and records relating to this
Agreement for a period of three (3) years following the date that this Agreemenl is expired
or otherwise terminated. The parties agree that the CITY OF AUBURN may inspect such
documents upon good cause at any reasonable time within the three (3) year pE~riod.
XI. TERMINATION OF AGREEMENT.
This Agreement may be terminated by either party upon ten (10) days written
notice should the other party fail substantially to perform in accordance with its terms
through no fault of the other.
---------.----------------------------
Agreement - OF -0201, Crisis Clinic Crisis Line
March 15,2002
Page 6 of8
--_._-_.~--~~-~--_._._-~---_._----~..__.-._-
XII. GENERAL PROVISIONS.
A. The AGENCY agrees to submit a report to the CITY no later than
December 15, 2002, describing the progress and activities performed for
the year 2002 under its scope of services.
B. This Agreement shall be governed by the laws, regulations and Qrdinances
of the City of Auburn, the State of Washington, and County of King and
where applicable, Federal laws.
C. The CITY and the AGENCY respectively bind themselves, their
successors, volunteers, assigns and legal representatives to the other
party to this Agreement and with respect to all covenants to this
Agreement.
D. This Agreement represents the entire and integrated Agreement between
the CITY and the AGENCY and supersedes all prior negotiations. This
Agreement may be amended only by written instrument signed by both the
CITY and the AGENCY.
E. Should it become necessary to enforce any term or obligation of this
Agreement, then all costs of enforcement including attorneys fees and
expenses and court costs shall be paid to the substantially prevailing party.
F. The AGENCY agrees to comply with all local, state and federal laws
applicable to its performance under this Agreement.
--------------------------------------
Agreement- OF-0201, Crisis Clinic Crisis Line
March 15, 2002
Page 7 of8
- __.".··_______m___ __.."__..__..____~_.___~__._____._~_
~2
PETER B-:-EWIS
MAYOR
-~
t~
=--0
,;rrT:
IfkJJt!![J,J~ /
Danielle E. Daskam,
City Clerk.
BY:
CRISIS CLINIC
¡¿~~
TITLE: Executive Director
STATE OF WASHINGTON )
)ss
COUNTY OF KING )
On this 3rd day of April, 2002, before me, the undersigned, a Notary Public in and for the
State of Washington, personally appeared Kathleen Southwick, to me known to be the Executive
Director of Crisis Clinic, the non-profit corporation that executed the within and foregoing
instrument, and acknowledged said instrument to be the free and voluntary act and deed of said
non-profit corporation for the uses and purposes therein mentioned, and on oath stated that he/she
is authorized to execute said instrument on behalf of said non-profit corporation.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal the date
hereinabove set forth.
ún..L~
Corai Letnes
NOTARY PUBLIC in and for the State of
Washington, residing in Shoreline. Washincton
MY COMMISSION expires: November 20. 2002
--------------------------------------
Agreement- OF-0201, Crisis Clinic Crisis Line
March 15,2002
Page 80f8
~ .......~_.~----~.....__.~-_._"~.__..~-
EXHIBIT 1, GF-0201
CITY OF AUBURN
HUMAN SERVICE AGREEMENT
2002 SCOPE OF SERVICES AND SERVICE UNIT REPORT
Agency Information
Crisis Clinic
1515 Dexter Ave. N. Ste 300
Seattle, W A 98109
ksouthwick@crisisclinic.org
206-461-3210
206-461-8368
Contact:
Kathleen Southwick
Title: Executive Directolr
Are professional services (e.g., counseling, case management) provided as part of this
Agreement? no
Contract Information
Contract Amount:
$1,500.00
Program Name:
Crisis Line
Description of Service to be provided: telephone services for crisis intervention, information and
refereal
Reporting Information
Report for _ January 1, 2002 to December 31,2002
2002 Service Units
City Funding All Funding Sources Actual Service
Only
Total Units to Date,
Service Unit Description: all Fund
Auburn Residents Only Projected Actual Units by Quarter Sources
Annual Units
Service Unit/Performance Measure 1" 2nd 3'd 4th
\,¡¡duplicated Number of Auburn 2,000
Clients Served'
Incoming Calls 169
Advocacy/Follow-up Calls 5
Referrals Provided 900
Narrative: Please attach other relevant information, including current trends, program developments,
special events, publicity, community education, etc. If actual service units are lower than anticipated,
please explain. 'Due to the nature of our service, we are unable to provide an unduplicated count.
We project that the Crisis Line will serve approximately 2,000 Auburn residents in 2002; however,
Auburn is funding only 174 of those contacts (174 calls X $8.63/call = $1,500). The remaining
1,826 Auburn calls will be subsidized by other funders.
-_._---"-~_._-~--~-~._----_..-
EXHIBIT 2, GF-0201
CITY OF AUBURN
2002 Financial Report
Agency: Crisis Clinic
Program: Crisis Line
Date:
Report for _ January 1,2002 to December 31, 2002
Cost Categories Budget This Cumulative Award
Award Request to date Balance
1 Personal/Agency Services $ 1,500.00
2 Office/Operating Supplies
3 Consultant or Purchased
Services
4 Direct Client Assistance
5 Communications
6 Travel & Training
7 Intra-Agency Support
8 Other per Detail
Grand Total $1,500.00
Requested
Reimbursement:
Detail as Applicable:
EXHIBIT 3, GF-0201
CITY OF AUBURN
2002 Demographic Report
Agency:
Program:
Crisis Clinic
Crisis Line
Date:
Cateaorv l' 2" 3 41n I Total YTD I
Client Alaana
Residence*· Auburn
Black Diamond
"list all clients Burian
served in this Covinaton
category. Des Moines
In all other
categories list Enumclaw
Auburn clients Federal Way
only. Kent
Maole Vallev
Normandv Park
Pacific
Renton
SeaTae
Seattle
Tukwila
Unincornorated. Kino County
Other:
Unknown
TOTAL
Client 30% of median or below
Income 50% of median or below
Level 80% of median or below
Above 80% of median
Unknown
TOTAL
Client Female
Gender Male
Client 0-4
Age 5-12
13-17
18-34
35-54
55-74
75+
Unknown
TOTAL
Ethnicityl Asian/Pacific Islander
Cultural Black/African American
Background HisDanidLatino
Native Americanl Alaskan Native
White/Caucasian
Other
Unknown
TOTAL
Condition Disablina Condition
ESL Limited Enaljsh Soeakina
Household Female-Headed Household
COVER PAGE, GF-0201
CITY OF AUBURN
HUMAN SERVICE AGREEMENT
2002 INVOICE FOR CONTRACTED SERVICES
To: City of Auburn, Attn: Shirley Aird, Planning Department
25 West Main, Auburn, WA 98001
Agency:
Crisis Clinic
Date:
1515 Dexter Ave. N. Ste 300
Seattle, W A 98109
206-461-3210
206-461-8368
ksouthwick@crisisclinic.org
Contact: Kathleen Southwick
Invoice for: 0 Preliminary, Cover sheet & Exhibit B only due December 13, 2002
o Year-end Final due January 31, 2003
Amount Requested: $1,500.00
Required Attachment Checklist: _ Exhibit A - Service Report
_ Exhibit B - Financial Report
_ Exhibit C - Demographic Report
_ Proof of Insurance (1st quarter and/or if expired since last
reimbursement request)
I certify to the best of my knowledge that this invoice and attachments reflect actual service provided to
Auburn residents.
Date
Signature of Authorized Representative
The City of Auburn will issue payment upon this invoice within thirty (30) business days of receipt. To
ensure prompt payment, please submit this form and all required attachments by the date listed above.
FOR CITY OF AUBURN USE ONL Y:
Contract Amount: $1.500.00
Payments Year to Date:
Date:
Date:
Date:
Date:
Contract Balance:
Payment this invoice:
Authorized to Pay:
Signature
Date
COVER PAGE - MUST BE SIGNED AND SUBMITTED WITH EACH PAYMENT REQUEST